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Model Healthcare Goes To Jail in Miami

NCJ Number
Modern Healthcare Volume: 5 Issue: 6 Dated: (June 1976) Pages: 41-43,45-48
G W Downey
Date Published
7 pages
This article describes the jail healthcare program operated by Jackson Memorial Hospital in Miami, Fla. Components of the program include nurse practitioners, a telemedicine system, and a compendium of standing medical orders.
The most recent national survey of jail care, conducted by the American Medical Association in 1972, showed that 16.7 percent of the 4,000 jails in this country had no provisions for healthcare. Another 65.5 percent had only basic first aid facilities, and only 7.9 percent had clinics or dispensaries. Further, the prevailing social attitudes, which currently favor harsher treatment, have contributed to poor healthcare facilities. Before Jackson Memorial Hospital took over the care of about 1,500 inmates in the Dade County jail system, healthcare was provided by a part-time physician and a 24-hour nursing staff with no hospital affiliation or inservice training. Following the deaths of eight or nine patients within a 3-week period, the hospital took over the jail healthcare program. In addition, the National Science Foundation made a $940,000 grant available to Jackson Memorial, the University of Miami, and the health systems department of Westinghouse Electric Corporation to upgrade jail healthcare. The hospital's jail health program manages about 79,000 patient visits per year with a staff of 45 full-time employees, a half-time medical director, eight part-time internists, a half-time psychiatrist, and consultants in dermatology and obstetrics-gynecology. Preliminary study results have indicated that there was no difference between the quality of care provided by nurse practitioners and the quality of care provided by physicians or between the quality of care provided via telemedicine and that provided onsite by physicians. On the other hand, the cost per patient visit dropped sharply when nurse practitioners were used. It is concluded that healthcare professionals, rather than jailers, hold the key to decent care for prisoners. Photographs and two articles on the Prisoner's Health Project and a reporter's reaction to a jail tour are appended.